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KAMPALA - Health minister Dr Jane Ruth Aceng has made a case for domestic mobilisation of resources to combat the malaria scourge following stagnation in external support.

She disclosed this on March 27, 2024, while interacting with the House committee on health chaired by Charles Ayume (Koboko Municipality, NRM) during deliberations on the ministerial policy statement for the 2024/25 Financial Year (FY).

The development comes on the back of a declaration the health ministers signed on March 6, 2024, during a high-level meeting during an engagement that brought together ‘high burden to high impact’ malaria countries (HBHI) countries in Yaoundé, Cameroon.

The countries included Burkina Faso, Cameroon, Democratic Republic of Congo (DRC), Ghana, India, Mali, Mozambique, Niger, Nigeria, Tanzania and Uganda.

Addressing lawmakers on Wednesday, Aceng said during the deliberations, development partners made it clear that they were not willing to increase funding because of competing priorities.

“I was there in person and was told the world has moved on to climate change issues, global security, to wars in Ukraine and Israel and many others. So, we were told to sign a declaration saying each of the 10 high-burden countries will look for their own domestic resources and bring their malaria pandemics or epidemics to an end by themselves. So I want to give you that information, I have also provided it to Cabinet,” Aceng said.

“At least our major donors, GAVI, Global Fund did not withdraw but they have not increased, they just levelled off. PEPFAR is running its own show but at least they invited us for a meeting tomorrow [March 28, 2024], maybe we shall have better news tomorrow. USAID continues to implement with Centers for Disease Control [and Prevention] (CDC) but quietly,” she added.  

However, generally speaking, Aceng pointed out that Uganda’s relations with donor relations, of late have not been at their best.

“The donor situation is not good. Donors are not talking to us at all. We are not even exchanging letters; they are not even allowed to interact with us. Even when we have our meetings they don’t appear. It is bad,” she said.   

However, on a lighter note, Aceng urged all and sundry to treat this as an eye-opener.

“But that should be good news for you because we cannot continue to rely on donors. We need to work on having our own resources. For me, the situation is good, it will teach us to be more frugal, prioritise better, be more efficient, maybe less corruption because corruption is already in our system,” Aceng said.

Malaria funding

Funding for malaria control has also dipped according to a March 6, 2024, World Health Organisation (WHO) communique.

“In 2022, $ 4.1 billion (about shillings 15.9 billion), just over half of the needed budget, was available for malaria response,” the statement indicates.

Comparably, a highly placed source at the health ministry, told New Vision Online that as Uganda, “we need to sit down and calculate the actual cost. What we get annually from global funds alone to support malaria is nearly $256 million (about shillings 994.7 billion).”

Cases

In contrast, the number of malaria cases across the globe two years ago, slightly rose to 249 million from 233 million in 2019. In the same period, the African region saw an increase in cases from 218 million to 233 million.

Thus far, the region continues to shoulder the heaviest malaria burden, representing 94% of global malaria cases and 95% of global deaths, an estimated 580,000 deaths in 2022.

Margret Ayebare (Mbarara District Woman MP, NRM) opined that the situation is likely to become dire given low sector funding and lack of a comprehensive health insurance scheme.  

“You sit in Cabinet, every time you come here, you tell us, it (National Health Insurance Scheme) is with the Cabinet. Can you look for it where it is at the cabinet level?” Ayebare remarked.     

 Epidemic surveillance

One of the areas that are likely to be affected by dwindling donor funds is epidemic surveillance.

Apparently, Dr Allan Muruta, the health ministry commissioner integrated epidemiology surveillance and & public health emergencies disclosed that “the funding that we have at the centre is roughly shillings 600 million and the rest at sub-national level including the points of entry (border) are largely funded by the donors”.

He added that they are usually embarrassed when they ask districts to respond during epidemics, only to be reminded that the officers are not facilitated.

“They just have to call on the partners to facilitate. But the partners also, by their own guidelines, we found that they are not allowed to support Government workers. So, that has been quite a challenge and we would be appreciative if we could get support from this committee,” he appealed.

Health Budge

Documents seen by New Vision Online indicate that the health ministry’s budget for the forthcoming fiscal year stands at shillings 1.328 trillion.

On the other hand, their approved budget for 2022/23 FY was shillings 3.6 trillion of which shillings 2.3 trillion was from the Government (63%) and 1.3 trillion (37%) was external financing.